HomeMy WebLinkAboutAgenda Statement 1984/09/04 Item 9 COUNCIL AGENDA STATEMENT
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• Item 9
Meeting Date 9/4/84
ITEM TITLE: Resolution //� Approving Extension of the Paramedics Service Contract with
Med Trans (DBA Hartson' s Ambulance Service)
SUBMITTED BY: Director of Public Safet` ,, (4/5ths Vote: Yes No x )
REVIEWED BY: City Manager p
On February 28, 1984, Council extended the Med Trans (DBA Hartson's) Paramedic Service to
September 8, 1984 with the understanding that a RFP would be developed and a provider would
be selected via a formal bid process. The RFP has been prepared.
RECOMMENDATION: That Council adopt resolution approving the extension of the paramedics '
service contract with Med Trans to February 8, 1985.
BOARDS/COMMISSION RECOMMENDATION: N/A
DISCUSSION:
In developing a RFP for paramedic service, staff has been concerned with the conflict that
might develop if the contract should be awarded to a medical provider other than Med Trans.
Currently, Med Trans is providing both ALS (paramedics) and BLS (EMT) medical services to
the service area which includes the City of Chula Vista and the Bonita/Sunnyside and
Montgomery Fire Districts. The ALS contract expires September 8, 1984, but the BLS contract
extends until February 8, 1989.
In calendar year 1983, there were 1 ,350 ALS transports and 3,970 BLS transports in the service
area. Experience would seem to indicate that a total of 1 ,350 ALS calls annually is not
sufficient to cover the annual expenses of an ALS unit. Med Trans (DBA Hartson 's) has
stated many times that the BLS transports pay for the ALS service. Medical service providers
have stated that at least four ALS transports per day are required to break even. If the
goal of four is not reached, then BLS transports must subsidize the ALS. program. If the
four per day figure is valid, the Chula Vista service area would require 1 ,460 ALS transports
annually compared with the 1983 total of 1 ,350 ALS transports. The new County Trauma Plan
will diminish the total number of ALS calls because the most serious calls will be transported
from the scene to the nearest trauma hospital by the Life Flight Helicopter.
Approximately 95% of the ALS calls are received, screened and dispatched by the City of Chula
Vista Communications Center. After an ALS unit arrives at the scene of an emergency call ,
the paramedics, after consultation with the base station hospital , may decide to make an
EMT transport. This is based on an analysis of the patient's medical condition.
The 3,970 BLS transports for 1983 originated from three sources :
1 . ALS calls that were downgraded to BLS calls.
2. BLS calls received by the Chula Vista Communications Center.
3. BLS calls received by the Med Trans Communications Center.
Form A-113 (Rev. 11/79) \,�
Item 9
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Meeting Date 9/4/84
If the successful ALS provider, in our RFP process, is a company other than Med Trans, we
will have a situation in which one company has the ALS contract and Med Trans has the BLS
contract. This will automatically create a situation in which the BLS provider will be
disputing the decision making process of the ALS provider if there is a significant increase
in the percentage of ALS transports. Such an increase may occur if the theory is valid that
BLS transports are necessary to pay for ALS costs. Staff feels that this potential conflict
will result in significant staff time in resolving disputes and monitoring the contract.
This situation could result in increased medical costs for subscribers if they are subjected
to ALS transports when BLS would suffice.
Staff recently became aware of Assembly Bill 3153 which adds Sections 1797.6, 1797.85 and
1797.224 to the State Health and Safety Code (attached) .
Section 1797.224 is most relevant to our situation and it is as follows:
"A local EMS agency may create one or more exclusive operating areas in the
development of a local plan, if a competitive process is utilized to select
the provider or providers of the services pursuant to the plan. No competi-
tive process is required if the local EMS agency develops or implements a local
plan that continues the use of existing providers operating within a local EMS
area in the manner and scope in which the services have been provided without
interruption since January 1 , 1981 . A local EMS agency which elects to create
one or more exclusive operating areas in the development of a local plan shall
develop and submit for approval to the authority, as part of the local EMS plan,
its competitive process for selecting providers and determining the scope of
their operations. This plan shall include provisions for a competitive process
held at periodic intervals. Nothing in this section supersedes Section 1797.201 ."
If this section is enacted, Chula Vista could, with the concurrence of the County EMS agency,
extend the current ALS contract with Med Trans until February 8, 1989 when the BLS contract
with Med Trans expires. We would then be able to go out to bid and have one provider for
both ALS and BLS services. This would eliminate the potential conflict that can exist with
different ALS and BLS providers.
AB 3153 has been amended by both the Senate and the Assembly and it is in Conference Committee.
The Legislature is due to recess on September 6, 1984 and reconvene December 6, 1984. At this
time there is no indication when the bill will come out of committee.
Staff is requesting that Council extend the current paramedic contract with Med Trans for
five months (until February 8, 1985) . If the legislation is passed, staff will work with
the County EMS office so that we may extend our paramedic contract until February 8, 1989
when the BLS contract expires. If the legislation is dropped, we will proceed with the RFP
process .
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